Abstract
Background
Mortality from tuberculosis is a sensitive indicator of health inequalities, given that the risk for its occurrence is related to the vulnerability of the territories.
Objective
To investigate whether the spatial variations of social determinants affect deaths from tuberculosis in a municipality in the Amazon region.
Method
Ecological study with multiple measures of analysis. The study was composed of deaths from tuberculosis as a basic cause in Manaus, Amazonas, Brazil, reported in the Brazilian Mortality Information System (2006-2015). In the analyzes, the crude and standardized rate was calculated, Moran Index was used to verify the spatial autocorrelation of mortality, and subsequently, the geographically weighted regression was applied to assess the inequality relationship of deaths from tuberculosis.
Results
731 deaths from the disease were identified. The distribution of mortality was heterogeneous, with high rates of death from tuberculosis in more socially vulnerable areas. The autocorrelation and spatial dependence was confirmed. The final model presented variables that indicate inequities: low income, poverty and education, showing their relationship with mortality.
Conclusion
It was evident that social determinants in the urban space influence mortality from tuberculosis in the region. Therefore, advancing public policies to correct health inequities can positively impact this scenario.
Keywords:
tuberculosis; mortality; spatial analysis; social determinants of health; residence characteristics